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Surgery can be a better way for treating hyperparathyroidism a leading cause for osteoporosis

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 Most of the osteoporosis cases are observed due to aging and a leading cause which is hyperparathyroidism, in which an excessive amount of hormone is released by the parathyroid glands which regulates the calcium levels of the body.

Bisphosphonates is a class of prescription drugs that is recommended by the practitioners for treating hyperparathyroidism which includes alendronate(Fosamax) and ibandronate (Boniva).

As per a study led by the researchers at UCLA shows that drugs recommended for hyperparathyroidism are increasing the risk for fracture more against no treatment taken for the condition. It has also been studied that the patients that underwent for surgery had less series of bone fractures.  

Study’s first author and an associate professor of surgery and medicine, Dr. Michael Yeh said that the major concern of the public health and economic burden is due to osteoporotic fractures as around 400,000 people in the U.S. -- 1 in 400 women and 1 in 1,200 men -- have hyperparathyroidism

The report appears in the April 5 issue of the Annals of Internal Medicine.

"Hip fractures in particular are associated with significant rates of mortality, disability and loss of independence," said Yeh, who also is the chief of endocrine surgery at the UCLA David Geffen School of Medicine. "Before this study, there was no data that compared parathyroid surgery with prescribing medication on the risk for fractures in people with hyperparathyroidism."

The data for more than 6000 people who were diagnosed with hyperparathyroidism from1995 and 2010 was analyzed by the researchers.

Following were the highlights from the study

There were 56 hip fractures per 1,000 people after 10 years for patients who were not treated for hyperparathyroidism.

For those who had parathyroid surgery, only 20 fractures per 1,000 people was observed

Rate of hip fractures was 86 per 1,000 patients for those who took bisphosphonates. The rate was higher than the combined rate of those who did not go for any treatment and the one who underwent surgery.

All types of bone fractures (including hip fractures) was reviewed by the researchers and same kind of results were again observed.

"The drugs make the bones look dense on scans, but that is deceptive," Yeh said. "We must presume there is a defect in the quality of the bone. But we don't know why."

It was also observed by the researchers that the risk of fractures was higher in patients who were taking bisphosphonates for conditions such as osteopenia, or early bone loss, or full-blown osteoporosis. As per Mr Yeh, this could indicate that either the drugs are harmful or there are some other risk factors associated with people who were taking the drugs.

"Regardless, we were unable to demonstrate any benefit associated with this class of drugs, which have been around and routinely prescribed for more than 20 years," he said. "These findings should make bisphosphonates less attractive as an alternative to parathyroid surgery in patients with primary hyperparathyroidism."

There is more research that is to be done as per Yeh, for checking if the class of drugs, bisphosphonates have higher risk of fractures for other causes of hyperparathyroidism such as lack of vitamin D, calcium or estrogen.

According to Pharmaion, pharma and healthcare study, "United States Osteoporosis Drugs Market Opportunities, 2011 – 2021", Osteoporosis affects more than 54 million people who are above 50 in the US and also a cause for bone fractures, which is around 2 million fractures a year. The study has revealed that one of the leading cause for Osteoporosis is hyperparathyroidism and the drugs that are used for treating this condition, known as bisphosphonates are increasing the risk of fracture. Surgeries are more successful for such condition as it helps in reducing the chances of subsequent bone fractures.





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